title: Perinatal outcome and long-term follow-up of extremely low birth weight infants depending on the mode of delivery.
abstract: OBJECTIVE
  To assess the effect of the mode of delivery (vaginal or cesarean section) on survival, morbidity, and long-term psychomotor development of extremely low birth weight (ELBW) infants.
  
  
  METHODS
  A longitudinal observational study including 138 ELBW infants (73 born by c-section and 65 vaginally) was conducted. We analyzed the survival and short-term morbidity. We also studied the long-term neurocognitive and motor development using the McCarthy Scales of Children's Abilities (MSCA).
  
  
  RESULTS
  Mortality was significantly higher in newborns delivered vaginally (49.3%) than those delivered by c-section (23.1%). Newborns delivered vaginally had a higher incidence of retinopathy and peri-intraventricular hemorrhage (P-IVH). Children who died had lower gestational age at birth and lower birth weight. After multivariate analysis only birth weight, gestational age at birth and P-IVH were independently associated to mortality. Regarding the long-term evaluation (MSCA), we observed that children born by c-section had lower incidence of abnormal results.
  
  
  CONCLUSIONS
  The mode of delivery does not affect survival. Cesarean section provides lower morbidity and better prognosis for neurodevelopment long-term outcome in ELBW infants.
authors.affiliation: Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, Pamplona, Spain.
authors.forename: José Angel
authors.initials: JA
authors.lastname: Minguez-Milio
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Alcázar
authors.forename: María
authors.initials: M
authors.lastname: Aubá
authors.forename: Alvaro
authors.initials: A
authors.lastname: Ruiz-Zambrana
authors.forename: José
authors.initials: J
authors.lastname: Minguez
mesh_terms: D000328:Adult; D002657:Child Development; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011597:Psychomotor Performance; D055815:Young Adult